Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision
making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question was
My Dad Is In A Critical State And I Want To Transfer Him To Another Private ICU. Will They Reject Him?
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“ I want to answer the succeeding questions from one of my clients Melanie as part of my 1:1
consulting and advocacy service! Melanie is asking how to stay calm and be positive amidst all concerns in transfer of his dad to the other hospital.
We Wanted our Dad to be Transferred to a Private Hospital. How Can I Stay Positive in Making Decisions for the Family?
“You can also check out previous 1:1 consulting and advocacy session with me and Melanie here.”
PART 1
PART 2
PART 3
Patrik: All I’ll do is basically, this is the situation. We’ve got this NFR situation. We want to buy time, and I’m not mentioning any
names, just giving them the situation. We want to buy time to get to a private hospital, what can we do? And given that they gave me a good answer today, they will give me an answer tomorrow.
Melanie: Yeah.
Patrik: Right?
Melanie: Yeah.
Patrik: So, I will write an email. I will send that to you tonight. I will …
Melanie: Thanks Patrik.
Patrik: Oh you’re welcome. I will tomorrow morning will contact St. Georgia Private will contact the office of the public advocate, and then we’ll see how we go from there.
Melanie: And look if we can even, if St. Georgia are happy to take him, like, on Saturday or Sunday …
Patrik: Absolutely!
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Melanie: If they can take him tomorrow I’m happy. If any of those hospitals can take him tomorrow, I know you said it might not be until Wednesday…
Patrik: I don’t think it will be.
Melanie: I will do anything, like whatever it takes.
Patrik: I’m with you. I’m totally with you, but having worked in hospitals and in ICUs for nearly twenty years, I don’t want to be negative, I just know how slow they are.
Melanie: Yeah. Well I’ll put a call in to my second cousin if I can catch him because again might be away, and Dr. Miller, and I’ll get back to you on where I get on that.
Patrik: Yeah.
Melanie: Because they might be able to pull strings to make it happen.
Patrik: Absolutely. And if you can think of anybody else you may know at St. Georgia, you know if you come up with something or anybody within your family.
Melanie: Yeah, I’ll have to think about it.
Patrik: You have to think, but I think for now those are our next steps.
Melanie: Mm-hmm (affirmative) okay. Okay. Thank you so much Patrik.
Patrik: Oh, you’re welcome. I’ll send you an email as soon as I’ve written it.
Melanie: And what I’ll do, my strategy with the intensive care staff is to not say a word about anything anymore. When he says, “is your friend going to call me?”
I’ll just say, no we’ve decided, what will I say …
Patrik: Nothing. I would just be quiet. I think you know on a clinical level you’ve been banging your head against a wall, right? There’s probably almost no point to argue on a clinical level anymore at this point in time. It needs to be taken out of the clinical environment for now.
Melanie: Yep
Patrik: I wouldn’t, you know, …
Melanie: If he asks, I’ll say I’m not sure.
Patrik: Yes, I’m sure you’ll find a way.
Melanie: Mm-hmm (affirmative). Okay and there’ll be no further discussions with any of those, no nurses, no intensivists, no nobody.
Patrik: Um. Okay. Are they planning to meet with you again tomorrow?
Melanie: No, he said he’ll be around if we need to meet with him, but I’ll just say no, we’ll just…
Patrik: Here’s another strategy. So, let’s just say god forbid there is any deterioration tomorrow and they would want to meet because … I wouldn’t meet if I were you, I wouldn’t meet. All I would say to them is, “I told you what we want, and that’s what you should be putting in place,” right? Because this could well be again, god forbid, if your dad deteriorates, they might say to you we’ve going to sit down because we think your dad is
deteriorating and he may not survive the next twenty four hours, but your point is very clear if that happens, so are they, rather than going into a meeting where they just reiterate what they’ve already said, in those meetings if anything you’ve only been burned haven’t you?
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Melanie: Mm-hmm (affirmative). Every time.
Patrik: Every time. So, you know, don’t go into those meetings.
Melanie: Mm-hmm (affirmative). Yeah. But sometimes they ask to have them at the bedside.
Patrik: That’s terrible. It’s terrible. Your dad is there, so basically they’re telling in front of your dad this, this, this, and this if he deteriorates. I mean that’s just, it’s awful.
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Melanie: Mm-hmm (affirmative). Yeah.
Patrik: Highly inappropriate.
Melanie: Yeah, I know. I know. It’s just been a nightmare.
Patrik: Yeah.
Melanie: But you think, if they approach us and say, god forbid, if there is any deterioration, we need to have the family meeting, we just refuse to have it. I’ve made my point clear what we want.
Patrik: Correct.
Melanie: And there’s no, I’m not entering into further conversation about it.
Patrik: Correct. And what you might say is to, and I think if it comes to that point, you almost need to say that we’re taking it out of a clinical level and seek advice.
You don’t need to go into detail. You’re talking to a CEO or director of nursing, that’s none of his business really because that’s a step you can take at any time.
All you can say is, “and we are taking this to another level.” That’s all you need to say.
Melanie: Mm-hmm (affirmative).
Patrik: You don’t need to go into details. He will find out sooner or later.
Melanie: Yeah. We’re taking it to another level.
Patrik: That’s right. That’s all you need to say. You don’t need to, some people they might say, “oh we are considering seeking legal advice.” You don’t need to, number one you’re not considering that at this state, and number two I don’t think you need that at this point in time.
Melanie: Mm-hmm (affirmative). Yeah.
Patrik: And what you might say if there is deterioration, you might say, “look we are trying to get a bed in a private hospital” you might say that. Because that might almost, again what they want is they want their bed empty and if you can show them that you are working on this, that might appease them for a little while.
Melanie: But it might get them even more fired up as well.
Patrik: Ummm.
Melanie: Because it feels like it’s a power thing to me.
Patrik: It probably is by now, but that shouldn’t be, I know it’s easier said than done, but it shouldn’t be your concern really. They’re on a power trip. We know all of that.
Melanie: Yes.
Patrik: But so be it, you know? I think I have found that if you show them that you are working on a solution that will help them as well, life in general works best if you are creating win-win situations. I see if you can help them empty their bed, that is a win for them too.
Melanie: Mm-hmm (affirmative). So, if the director gets it tomorrow, this email, will they take action immediately do you think?
Patrik: I think so. I think so. I really think so. They have to.
Melanie: And if they don’t, then the options of advocacy will.
Patrik: Well I would hope so. I will ask that question tomorrow. I will ask that look we’ve made the complaint, right? It’s Friday today. It’s a long weekend. This is the situation. What if they don’t respond? But I also don’t think that it’s too much to, okay, besides the complaint, I don’t think it’s too much to ask for you to meet with the director of nursing or the CEO. I don’t think that’s too much to ask at all.
Melanie: Mm-hmm (affirmative).
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Patrik: If you feel you have the power and the energy of course, I get it. You’re over it. I totally get it.
Melanie: I might have to fly you to Sydney for that one.
Patrik: Look, I, I probably could do next week, but..
Melanie: Yeah, I know.
Patrik: No but …
Melanie: Yeah, I know.
Patrik: I don’t think it’s too much to ask for a meeting.
Melanie: With the director?
Patrik: No not at all, If this is a life or death situation, and you know how frustrating the public system can be. The CEO or the director of nursing, look I would be very surprised if they were not taking your concerns seriously. I really would.
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Melanie: Yeah. Mm-hmm (affirmative). Okay. And you say do ask for a meeting.
I’m not going to get into the clinical side.
Patrik: No. You’ve heard it all. This is purely about buying time …
Melanie: Should get him into …
Patrik: Into private.
Melanie: Private. Yeah.
Patrik: And it maximises chances for survival.
Melanie: Mm-hmm (affirmative) okay. Okay. Alright.
Patrik: Let’s do this tomorrow morning and get a feel for the patient liaison. If you think they’re too slow, they’re not responsive, if you think they’ve got their own agenda, I wouldn’t waste my time. I would just go straight onto that executive level.
Melanie: Yeah I’d rather do that.
Patrik: Yeah. I wouldn’t …
Melanie: That’s another process I have to step away from dad’s bedside when it’s really important to be there to help encourage his breathing and keep him because the nurses put on the Swedish um..
Patrik: The Swedish nose.
Melanie: The Swedish nose and then just go, “oh yeah, did he do his hour?”
They don’t sit there and encourage him along, so I’m sitting there encouraging him to keep his heart rate down and all that sort of stuff, and if it’s making a difference, so I don’t want to have to step away from the bedside to go and talk to liaison or whoever. I’d rather just cut to the chase and do it and if I’m not heard at the director level then I don’t know we go from there, but yeah. And I’ll put a call into those two doctors tomorrow morning, as well and
see if they can pull some strings.
Patrik: Right. Are you at the ICU overnight as well?
Melanie: No, I wish I could be but I need to come home to sleep.
Patrik: Oh absolutely.
Melanie: Yeah it’s been … but I’m concerned about leaving him especially with all this stuff up in the air because I don’t know what happens there at night.
Patrik: Well probably not much.
Melanie: Yeah. But I’m just worried whether they do something to him.
Patrik: I don’t think they do. I’m not concerned about that they do anything to harm him. I don’t have any concerns there. What I am concerned about is that they’re not really proactive to, as you said, try and wean him, and obviously the biggest concern is that they wouldn’t be proactive in case of deterioration. I think they’re sort of fairly passive, they’re doing what they do with all of their ICU patients in situations like that.
I’m not worried that they do any harm for him, deliberately trying to make him worse. That would be really shocking, and I haven’t actually seen any of that.
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Melanie: Yeah.
Patrik: But it’s that proactiveness.
Melanie: I know. I come home every night and I haven’t been able to sleep properly, and I’m always worried about it. I’m worried about him being less there, and I heave on that. Yeah, so. Yeah. Are you asking for any particular reason whether I’m there overnight?
Patrik: Yeah, the reason I’m asking is you are probably the most important person in all of this. If you are not rested, it’s not going to work.
Melanie: Yeah, I know I realised that because I could see already there are days where I’m so exhausted, I can’t even conduct myself in a meeting.
Patrik: So, you know I have an article on my website that basically says the three most dangerous mistakes families are making in intensive care, and one of those mistakes is spending day and night in intensive care.
Melanie: Yeah, I actually read that earlier on when I first discovered your website. Yeah, I found that really helped me.
Patrik: So, if you are not functioning, you’re the decision maker it sounds like you’re in the rest of your family.
Melanie: Yeah.
Patrik: If you are not functioning, you’re not going to help your dad.
Melanie: Yes, I know. Yeah
Patrik: And having worked shifts for many years and having worked night shifts for many years, it’s not good to be awake at night.
Melanie: Yeah, I know
Patrik: That’s why I’m asking.
Melanie: Yeah and I’m so gratefully that you’re, I can say I need to be at the bedside can you help me with that, and you’re so happy to help with all these things ’cause I couldn’t even, I write painting material as a profession and I’m like, for me to sit and write an email at the moment is so overwhelming …
Patrik: Yes.
Melanie: Because my mind is so taken up with dad.
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Patrik: Yes, absolutely. I will write an email. I will send it to you tonight, and we’ve got a plan for tomorrow morning. I’ve got a meeting tomorrow morning from ten to ten-thirty, but any other time I’m available.
Melanie: Okay.
Patrik: And yeah. We’ll take it from there.
Melanie: Okay great. Thank you so much Patrik.
Patrik: You’re most welcome.
Melanie: I really appreciate it.
Patrik: You’re most welcome.
Melanie: Okay.
Patrik: Have a good rest.
Melanie: Thank you have a good night. Bye
Patrik: Okay thanks. Bye bye.
Melanie: Bye bye. Bye.
The 1:1 consulting session will continue in next week’s episode.
Kind Regards
Patrik
